Analysis of Maternal Positions during the Dilation and Expulsive Phase and Their Relationship with Perineal Injuries in Eutocic Deliveries Attended by Midwives.

This cross-sectional descriptive study aimed to analyze the relationship between maternal positions during the expulsion phase and perineal outcomes in 367 eutocic births attended by midwives or midwifery residents at a public hospital in northern Spain in 2018. A total of 94.3% of women opted for horizontal positions. Limited sacral retroversion was observed in 71.7%, potentially influencing perineal outcomes. A low incidence of tears indicated effective management during the expulsive phase, with an episiotomy rate of 15.3%, which was slightly above the 15% standard. Primiparity and maternal age were identified as risk factors associated with episiotomy. Additionally, sacral mobilization and vertical positions during delivery were significantly related to fewer perineal injuries, suggesting benefits for both mother and newborn. The correlation between maternal positions and the need for epidural analgesia highlighted the importance of considering these in pain management during childbirth. Despite limitations, the study provides valuable insight into obstetric practices and advocates for a woman-centered approach that respects autonomy during childbirth. Further research is needed to explore biomechanical parameters and enhance childbirth experiences.

Detección precoz de depresión prenatal en gestantes de Lugo / Early detection of prenatal depression in pregnant women from Lugo

Objetivo: Estimar la frecuencia de síntomas depresivos en mujeres embarazadas y establecer los factores relacionados con su presencia. Metodología: Estudio descriptivo, observacional y transversal. La población de estudio fueron mujeres gestantes que autocumplimentaron los cuestionarios PHQ-2 y PHQ-9 en el tercer trimestre de gestación, entre mayo de 2017 y mayo de 2018. Resultados: La muestra obtenida fue de 209 gestantes. Los resultados mostraron que un 19,6% de mujeres presentaron síntomas depresivos. Se obtuvo una relación estadísticamente significativa entre ser primigesta, no planificar el embarazo, tener una vivencia negativa del embarazo y presentar antecedentes personales de salud mental, con la presencia de síntomas. Los datos también pusieron de manifiesto que planificar el embarazo es un factor protector. Conclusiones: La frecuencia de los síntomas depresivos fue elevada. Se debe prestar especial atención a los factores protectores y de riesgo relacionados que influyan en la aparición y/o gravedad de síntomas depresivos, así como fomentar la prevención, detección precoz y tratamiento multidisciplinario de la depresión perinatal. (AU)

Objective: Estimate the frequency of depressive symptoms in pregnant women and establish factors related to their presence. Methodology: Descriptive, observational and transversal study. The study population were pregnant women who self-fulfilled the PHQ-2 and PHQ-9 questionnaires in the third trimester of gestation from May 2017 to May 2018. Results: The sample obtained was 209 pregnant women. Results showed that 19.6% of women had depressive symptoms. A statistically significant relationship was obtained between being primigesta, not planning pregnancy, negative pregnancy experience and personal mental health history, with the presence of symptoms. The data also showed that planning pregnancy is a protective factor. Conclusions: The frequency obtained from depressive symptoms was high. Particular attention should be paid to related protective and risk factors that influence the onset and/or severity of depressive symptoms; encourage the prevention, early detection and multidisciplinary treatment of perinatal depression. (AU)